Mechanical Thrombectomy for Acute Ischemic Stroke

Current global standard treatment for acute ischemic stroke due to large or medium vessel occlusion is mechanical thrombectomy. Intra-venous thrombolysis (clot-bursting drug) can be administered up to 9 hours of stroke symptom onset for stroke due to small vessel occlusion. Mechanical thrombectomy can be offered up to 24 hours depending on presence of viable brain tissue on perfusion scans.

This is by far the most life giving minimally invasive neurovascular procedure in the world. This offers the best functional outcome for patients presenting with acute ischemic stroke. Seeing in-bound patients on a trolly due to limb weakness walk the next day, hearing completely mute patients talk few hour after procedure are few of the common occurrences after successful thrombectomy treatment.

Dr KV has the most experience in mechanical thrombectomy in the region having performed hundreds of successful procedures achieving excellent patient outcomes. The Royal London hospital, where he worked is the busiest stroke thrombectomy center in western Europe.

Brain aneurysms when they bleed cause catastrophic clinical effects with death being up to 50% in the first week if left untreated. Treatment through endovascular methods have become as efficient as surgical clipping while having much less complications than open surgery. Recovery post endovascular treatment is much faster than open surgery. Technological developments like Flow-diverting stents and intra-saccular devices make aneurysms of any size, shape and location be treated safely and effectively through a pin-hole endovascular procedure through an artery in the wrist or groin.

Dr KV has vast experience in treating complex brain aneurysms both ruptured and unruptured. During his time as consultant at the institute of neurological sciences, Glasgow, he successfully treated numerous complex aneurysms using advanced devices and efficient strategies.

Cerebral and spinal vascular malformations are often complex and require thorough expert evaluation to analyze risk and plan most effective treatment or surveillance strategies. Brain AVMs have treatment options of surgery vs endovascular embolization vs Stereotactic radiosurgery or at times hybrid treatments combining more than one modality.

Dr KV was a key member of the multidisciplinary team including gamma knife specialist, expert vascular neurosurgeons that discussed treatment strategies for brain and spine vascular malformations and gained valuable insight in to assessing risks and planning treatment. He is well-versed with use of liquid embolizing agents like Onyx, PHIL, Squid and Histocryl for treatment of brain and spine vascular malformations.

One of the latest techniques to treat recurrent SDH is embolization of middle meningeal artery (MMA). It entails blocking of the MMA on both sides using liquid embolization agents. This procedure has been found to be very effective in preventing SDH recurrence thus help avoid repeated surgical procedures. Due to the minimally invasive nature this can be performed as day-case procedure and under local anesthetic.

Dr KV is one of the few early operators to perform MMA embolization in the UK with phenomenal success rates.

Endovascular treatment for blood vessel problems of the brain and spine can be done through a small sheath placed in an artery in the groin or the wrist.

Trans-radial neurointervention is when brain vascular treatment procedures are done through an artery in the wrist enabling more patient comfort, less complications and ultra-fast recovery.

Dr KV is a pioneer in trans-radial neurointervention and has done large volume of complex therapeutic neurovascular procedures through the wrist.